Individual
DARCIE RAINA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3429 CREEK VIEW DR, MEDFORD, OR 97504-9624
(541) 727-8685
Mailing address
3429 CREEK VIEW DR, MEDFORD, OR 97504-9624
(541) 727-8685
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6842
OR
Other
Enumeration date
04/15/2017
Last updated
04/15/2017
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